Ear to the Ground is a blog for development professionals, business owners, and others in Portland and the Northwest. Our attorney contributors share relevant and timely insight into real estate, energy law, water law, and environmental issues.

Housecalls Are No Longer a Thing of the Past

Real Estate and Land Use

If you know what a housecall is, you've dated yourself. If your doctor has ever made a housecall to you, you've really dated yourself. Or maybe not, as housecalls are staging a comeback – recent data shows they can save serious healthcare dollars. Portland-based nonprofit Housecall Providers leads the way, providing in-home medical services for homebound patients across the Metro area.

The range of care provided by Housecall Providers and similar service providers covers all stages of life, from primary care through hospice services. Transitional care to manage recovery following emergency room visits and hospitalizations is emphasized, to improve the healing process and reduce the likelihood of a return to the hospital. Many medical procedures can be performed in-home as well, like x-rays, EKGs, ultrasounds, lab testing, immunizations, and minor surgery. Visits are normally scheduled during regular business hours, but clinicians are available on call 24/7.

Housecalls are on the rise in part based on findings of the Medicare demonstration project Independence at Home, a federal pilot project studying housecalls made to around 10,000 Medicare beneficiaries at 15 sites across the nation. Total savings in the second year of the project exceeded $10 million. Housecall Providers is one of the participants, and in 2016 it saw average savings of $830 per patient per month, a savings of 26% over a control group.

Housecalls are part of a broader trend away from out-of-home care for the chronically ill and others in need of long-term care. For example, care for seniors and developmentally disabled persons in Oregon has been moving away from the institutional and group home models for years, toward more in-home and community-based care. While these changes have been spurred by the Affordable Care Act, the trend saves real dollars and is likely to continue regardless of the fate of the ACA.

The real estate implications of these trends could likely be numerous. Investment in medical office complexes, hospitals, senior living facilities, and group homes may wane in favor of infrastructure to support service providers that visit patients in their homes or other community settings. They may no longer wear a three-piece suit and carry a black leather bag, but medical professionals making housecalls may once again be coming to a home near you.